Download System of the body (part II: the nervous system) teaching programme

System of the body (part II: the
nervous system)
teaching programme
Chapter 1
Organization of the nervous system
【Aims and requirements】
1．Know well about the microstructure of cerebral cortex,cerebellar cortex
and spinal cord.②know the microstructure and function of blood-brain
barrier.
2．Know the basic components of central nervous system and peripheral nervous
system.
3．Know the relationship between nervous tissue and nervous system;know the
microstructure of meninges.
【Teaching hours】2 (100 min)
【Teaching contents】
1.summary：explain in detail about the basic components of nervous system. 1.in
central nervous system,put the emphasison the microstructure of cerebral
cortex,cerebellar cortex and gray matter of spinal cord.
2.in peripheral nervous system, introduce simply about the microstrucure of
cerebrospinal and autonomic ganglia .
3.introduce the microstructure of meninges.
4.to explain in detail about the microstructure and function of blood-brain barrier.
5.to introduce the microstructure and composition of choroid plexus.
Chapter 2 Development of nervous system
【Aims and requirements】
1.to know well about the development and early differentiation of neural tube and
neural crest; to know well about common malformations of nervous system
2.the know well about the development of brain, cerebellum and spinal cord.
3 to know the development of ganglion and peripheral nerve.
【Teaching hours】2(100 min)
【Teaching contents】
1. review of the nervous system.
2. to explain in detail about the development and early differentiation of the neural
tube and neural crest.
3. in central nervous system ,we focuse on the occurrence of cerebral cortex,
cerebellar cortex and spinal cord tissue.
Chapter 3 Development of eye and ear
【Aims and requirements】
1.to know well about the development of corneal and retinal tissue; to know well
about the development of inner and middle ear.
2. to know the development of iris, lens, vitreous, ciliary body and optic nerve tissue;
to know the development of external ear.
3. to know the development of the lid and lacrimal gland; to know the histogenesis of
auricle.
【Teaching hours】2(100 min)
【Teaching contents】
1. development of eyeball：formation of optic vesicle,optic cup and lens vesicle；
development of retina, optic nerve,lens and tunica vasculosa and sclera.
2. congenital malformations of eye.
3. development of inner ear: formatio of otic placode and otic vesicle.
4. development of middle ear: formation of primary tympanic cavity and tympanic
cavity，development of the 3 ear bones。
5. development of external ear: the histogenesis of the external acoustic meatus and
auricle。
6. congenital malformations of ear.
Chapter 4 Elements of Cellular and Molecular Neuroscience
【Aims and requirements】
To master the classification and characteristics of channels.
To be familiar with the method for bioelectrical phenomena research, including the recording
membrane potential，the researching of ion basis of membrane potential，the electrochemical
equilibrium and Nernst equation.
To master the definition of resting membrane potential, polarization, depolarization,
reverpolarization, repolarization, hyperpolarization.
To master the definition of action potential.
To master the mechanism generating action potential of nerve.
To be familiar with the wave form of nervous action potential recorded by a intracellular electrode
in a nervous fiber, including the evidences to show depolarization of nervous action potential is
due to Na+ inflow and repolarization is due to K+ outflow.To master the mechanism of
propagation of action potential.
To master the characteristics of action potential.
To master the definition and characteristics of local potential.
To understand the propagation of action potentials along a myelinated nerve fiber.
To understand the change of cell excitability during one action potential.
【Teaching hours】: 6 hours
【Teaching contents】
1. The structure, function and properties of different ion channels
2. The property and mechanism of resting potential
3. The property and process of action potential
4. The cellular and molecular mechanism underlying the initiation of action potential.
The voltage clamp recording and patch clamp recording..
5. The local response (excitation) on the membrane.
6. The propagation of action potential on the cell membrane.
Chapter 5 Synaptic transmission
【Aims and requirements】
1. To master the process of synaptic transmission, which includes the events occurres
at presynapse, cleft and postsynapse.
2. To understand the EPSP and IPSP.
3. To master classification of receptors on postsynapse and the mechanisms.
【Teaching hours】: 2 hours
【Teaching contents】
1.
The classification of synapse, and characters of chemical synapse.
2. Signal transduction of chemical synapse, which includes the neurotransmitter
synthesis, storage and release, binding of postsynaptic receptors, and
inactivation of neurotransmitter.
3. Excitatory postsynaptic potential (EPSP) and Inhibitory postsynaptic potential
(IPSP).
4. Synaptic integration-sptial summation of EPSPs, temporal summation of
EPSPs.
5. Synaptic inhibition and synaptic plasticity.
Chapter 6 Neurotransmitter
【Aims and requirements】
1. To master the definition and classification of neurotransmitter.
2. To master the differences between classical neurotransmitters and the
non-classical neurotranmitters.
3. To master the chemical changes of specific neurotransmitter (ACh, NE, DA,
5-HT, Glutamate, GABA), which includes synthesis of neurotransmitter,
storage of neurotransmitter, release of neurotransmitter and inactivation of
neurotransmitter, postsynaptic transmission.
4. To understand the classification of postsynaptic receptors and functional
mechanisms.
【Teaching hours】: 2 hours
【Teaching contents】
1.
The concept of neurotransmitter. The classification of neurotransmitters.
2.
The synthesis of neurotransmitter, storage of neurotransmitter, release of
neurotransmitter and inactivation of neurotransmitter, postsynaptic receptors.
3.
Several classical neurotransmitters. 1) ACh-; The key enzymes for its
synthesis and degradation; M receptors and N receptors, and their functional
mechanisms. 2) catecholamine neurotransmitters; the common precursor Tyr; The
key enzymes for NE, DA synthesis; inactivation is mainly by reuptake; 3) 5-HT;
inactivation is mainly through reuptake. 4) amino acid neurotransmitters-a.
excitatory amino acid, glutamate; its rececptors AMPA and NMDA, and their
characters. b. inhibitory amino acid-GABA, its mechanism and receptor characters.
Chapter 7 Introduction to pharmacology of efferent nervous system
【Aims and requirements】
1. To know well classification of efferent nervous system (ENS) according to the
neurotransmitters, the physiological actions of ENS, as well as receptor structure
and molecular mechanism.
2. To master the biosynthesis, storage, release and termination of neurotransmitters, as
well as the receptor subtypes and their effect.
3. To master the basic mechanisms of actions of ENS drugs and their classification.
【Teaching hours】: 0.5 hour
【Teaching contents】
1. Review the anatomic classification of ENS.
2. Neurotransmitters of ENS: the development of neurotransmitter theory, synaptic
structure and impulse transmission, as well as the biosynthesis, storage, release and
termination of NE and Ach.
3. Receptors of ENS: acetylcholine receptors (M-R, N-R and subtypes), adrenoceptors
(-R, -R and subtypes), and their distribution and function.
4. The classification of ENS according to the neurotransmitters: cholinergic nerve and
noradrenergic nerve.
5. The biochemical process of ENS effect: Ligand-gated receptor and
G-protein-coupled receptor.
6. The physiological actions of ENS.
7. The basic mechanisms of actions of ENS drugs and their classification.
Chapter 8 Parasympathomimetics
【Aims and requirements】
1. To know well the M actions and N actions of Ach.
2. To master the effects and uses of pilocarpine on eye.
3. To master the pharmacological effects, clinical uses and adverse reactions of
neostigmine.
4. To know well the mechanism, pathway, manifestation, prevention and treatment of
organophosphates intoxication. To master the mechanisms of cholinesterase
reactivator.
【Teaching hours】: 1.5 hour
【Teaching contents】
1. The M actions and N actions of Ach.
2. The effects and uses of pilocarpine on eye and glands: miosis, decrease intraocular
pressure, spasm of accommadation and increase glands secretion.
3. Pharmacological effects of ChEI. true Cholinesterase (AChE) and
pseudocholinesterase, the pharmacological property and clinical uses of common used
agents (neostigmine, pyridostigmine, physostigmine, etc. )
4. The mechanism, pathway, manifestation, prevention and treatment of
organophosphates intoxication. acute intoxication, chronic intoxication, cholinesterase
reactivator.
Chapter 9 Cholinoceptor blocking drugs
【Aims and requirements】
1. To master the pharmacological effects, clinical uses and adverse reactions of
atropine. To master the pharmacological property of scopolamine.
2. To know well the characteristics and uses of synthetic atropine substitutes.
3. To know well the characteristics and uses of ganglionic blocking drugs.
4. To master the characteristics, mechanism, uses and adverse reactions of both
neuromuscular blocking drugs.
【Teaching hours】: 2 hour
【Teaching contents】
1. atropine, scopolamine, anisodamine: pharmacological effects, clinical uses and
adverse reactions.
2. synthetic atropine substitutes: synthetic mydriatics, synthetic antispasmatics,
Selective M1 Antagonists.
3. ganglionic blocking drugs: NN-R blockers.
4. neuromuscular blocking drugs: NM-R blockers including depolarizing skeletal
muscle relaxant such as succinylcholine, as well as nondepolarizing skeletal muscle
relaxants such as D-tubocurarine.
Chapter 10
Pain and analgesia
【Aims and requirements】
1. To master the definition of pain, nociceptors, referred pain and gate control theory.
2. To master the pathways by which nociceptive information is transmitted from the
periphery to the cortex.
3. To master the main mechanisms whereby nociceptive transmission can be
modulated at the spinal and supraspinal levels.
4. To master the characteristics, mechanism, uses and adverse reactions of opioid
analgesic drugs.
5. To know well the characteristics of opioid antagonist-naloxone.
6. To know well the mode of administration of opioids.
7. To master mechanism, uses and adverse reactions of NASIDS.
8. To know well the approaches to pain management.
【Teaching hours】: 4 hours
【Teaching contents】
1. The definition and the significance of pain.
2. The nociceptors and pain pathways: the characteristics of nociceptors; the
ascending pathways and their roles in the formation of complex experience of pain.
3. The definition and mechanism of referred pain.
4. The modulation of pain in the spinal cord: gate control theory. The applications of
this theory in life.
5. The involvement of brain areas in descending analgesia. The mechanisms and the
applications of descending analgesia.
6. Opioid analgesic drugs: mechanisms (opioid peptides, opioid receptors), effects,
clinical uses, adverse reactions.
7. Common used opioid analgesics: such as morphine, codeine, pethidine, methadone,
fentanyl, tramadol, and so on.
8. Opioid antagonists.
9. The mode of administration of opioids.
10. The mechanism of NSAIDS.
11. Common used NSAIDS: aspirin, paracetamol, ibuprofen
12. The approaches to neuropathic pain, migraine, trigeminal neuralgia.
Chapter 11
Motor systems II: the basal ganglia and parkinson’s disease
【Aims and requirements】
1. To understand the organization of the basal ganglia and their connections with
other central nervous system regions.
2. To understand the main symptoms and diseases associated with dysfunction of the
basal ganglia, and their pathophsiology.
3. To master the pharmacological effects, mechanism of action, clinical uses and
adverse reaction of common anti-Parkinson drugs.
3. To know the pathogenesis of Parkinson’s disease
【Teaching hours】:2 hours
【Teaching contents】
1. The basal ganglia: structure and organization
2. Parkinson’s disease
(1) Symptoms
(2) Pathophysiology of Parkinson’s disease
(3) Causes of of Parkinson’s disease
(4) Treatment
Dopaminergic medication
L-DOPA:
Dopaminergic agonists
Monoamine oxidase B inhibitors
Non-dopaminergic medication
Anticholinergic agents
Amantadine
Chapter 12 Learning and memory
【Aims and requirements】
1. To master the definition of learning, memory, declarative learning, procedural
learning, anterograde amnesia, retrograde amnesia, long-term potentiation, long-term
depression.
2. To master the molecular mechanism of LTP.
【Teaching hours】: 4 hours
【Teaching contents】
1. The definition and the classification of learning and memory.
2. The involvement of the brain areas in learning and memory.
3. The definition and the molecular mechanism of long-term potentiation.
4. The definition and mechanism of long-term depression.
Chapter 13 Anti-Alzhemier’s disease drugs
【Aims and requirements】
1. To understand the genetics and pathophysiology and Alzhemier’s disease
2. To master the main classes of drugs and their pharmacological actions, clinical
uses and adverse reaction of Anti-Alzhemier’s disease drugs
【Teaching hours】:2 hours
【Teaching contents】
1. Alzhemier’s disease
Genetics of Alzhemier’s disease
Neuropathology of Alzhemier’s disease:
2. Treatment of Alzhemier’s disease
(1)Cholinesterase inhibitors
(2) Glutamatergic agents
(3) Antioxidants
(4) Non-steroidal anti-inflammatory drugs
(5) others
Chapter 14 Sedative-hypnotics and anti-epileptic, anti-seizure drugs
【Aims and requirements】
1. To master the pharmacological action, mechanism and clinical uses of
Benzodiazepines
2. To know well the pharmacological action, clinical uses and the rescue of
intoxification of Bartibuturates.
3. To know the characteristics of other sedative-hypnotic drugs.
4. To master the pharmacological action, mechanism and clinical uses, adverse
reactions of Phenytoin sodium, carbamazepine,Phenobarbital and ethosuximide.
5. To know the anti-convulsant effect and clinical uses of MgSO4
【Teaching hours】:2 hours
【Teaching contents】
1. The function of sleep and the sleep stages
2. The classification of sedative-hypnotic drugs and their characteristics
(1) Benzodiazepines: pharmacological action, mechanism, clinical uses, main
adverse reactions
(2) Barbiturates: structure-activity relationship, classification, mechanism of action,
clinical uses, adverse reactions and rescue of acute intoxification.
(3) Other drugs: chloral hydrate, meprobamate and melatonin
3. Anti-epileptic drugs
The main types of epilepsy, epidermiology, neurobiology and mechanism of
anti-epileptic drugs
Main anti-epileptic drugs:
(1) phenytoin sodium
(2) carbamazepine
(3) ethosuximide
(4) sodium valproate
(5) benzodiazepine
4. Anti-convulsant drugs:
Magnesium sulfate
Chapter 15
Infections and Tumors of Central Nervous Systen
【Aims and requirements】
1. To master the pathological changes and clinical features of epidemic bacterial
meningitis, epidemic encephalitis B and poliomyelitis
2. Be familiar with the main pathologic findings of astrocytoma, meningioma and
neuilemmoma
3. To know the common complications of central nervous system dieses.
【Teaching hours】: 4 hours
【Teaching contents】
1. Introduction of central nervous system including normal cells and basic
pathological changes
2. Infections in central nervous system including epidemic bacterial meningitis,
type B epidemic encephalitis, poliomyelitis
3. Common complications of central nervous system dieses including increased
intracranial pressure and herniation of brain, edema, hydrocephalus and
meningeal irritation
4. Tumors of central nervous system including astrocytoma, meningioma,
neuilemmoma, medulloblastom and neurofibroma.
Chapter 16 Schizophrenia
【Aims and requirements】
1. To know well the main symptoms and aetiology of schizophrenia.
2. To know well the neurobiology of schizophrenia.
3. To master the classification, effects, uses and adverse reactions of antipsychotic
drugs.
4. To know well the management of schizophrenia and the long-term prognosis.
【Teaching hours】: 2 hour
【Teaching contents】
1. Symptoms and aetiology of schizophrenia.
2. The neurobiology of schizophrenia: structure, functional and neruopathological
studies, psychophysiological changes, corticolimbic circuits, and neurotransmitters.
3. The classification, effects, uses and adverse reactions of antipsychotic drugs.
4. Common used drugs: chlorpromazine, fluphenazine, haloperidol, sulpiride, etc.
5. The management of schizophrenia and the long-term prognosis.
6. Other psychosed and schizophrenia-like syndromes.
Chapter 17 Depression and anxiety
【Aims and requirements】
1. To master the classification, mechanism of action and characteristic of
anti-depressant drugs.
2. To understand the mechanism and antimanic action of lithium carbonate.
3. To understand the neurobiology of depression.
【Teaching hours】:2 hours
【Teaching contents】
1. Introduction of depression, and symptoms, epidermiology and neurobiology.
2. Treatment of Depression—Pharmacological managenment
(1) TCAs: mechanism of action and characteristics
(2) MAOIs: mechanism of action and characteristics
(3) SSRIs: mechanism of action and characteristics
(4) SNRIs: mechanism of action and characteristics
3. Treatment of mania
(1) Pathology and symptoms of mania
(2) The mechanism of lithium carbonate in the treatment of mania and cautions
4. Treatment of anxiety
(1)Introduction of anxiety
(2) Benzodiazepines: mechanism of action in the treatment of anxiety
Chapter 18
Stroke and Treatment
【Aims and requirements】
1.To master the actions, mechanisms, indications and adverse reaction of nimodipine,
aspirin and tissue-type plasminogen activator(tPA) in the treatment of ischemia
cerebrovascular disease.
2.To master the pathophysiological mechanisms of ischemia cerebrovascular disease.
3. To know well the characteristics of other drugs for the treatment of ischemia
cerebrovascular disease.
4. To know well the progress of the drugs in the treatment of ischemia cerebrovascular
disease.
5.To understand the harm of the ischemia cerebrovascular disease(stroke).
【Teaching hours】: 2 hours
【Teaching contents】
1.The pathophysiological mechanisms of ischemia cerebrovascular disease and the
preparation of the animal models.
(1) The pathophysiological mechanisms of ischemia cerebrovascular disease
a. Energy disturbance
b. Excitotoxicity
c. Calcium overload
d. Oxygen free radical injury
e. Renin-angiotensin system disorder
f. Arachidonic acid（AA）metaboliam disorder
g. NO
h. inflammation and adhesion molecules and ischemic cerebrovascular disease
(2) The preparation of the brain ischemia animal models.
(3)The determination of cerebral blood flow
(4)The methods for studying blood-brain barrier
2.The drugs in the treatment of acute brain ischemia
(1)The drugs in the treatment of brain edema
(2)Calcium antagonists
(3)Vascular dilators
(4)Anti-platelet drugs
a.Cyclo-oxygenase inhibitors（COXI）
Aspirin and other drugs.
(5)Thrombolytic drugs
The action, indications and adverse reactions of streptokinase (SK), urokinase
(UK)and tissue-type plasminogen activator(tPA) in the treatment of ischemia
cerebrovascular disease.
3.Drugs in the treatment of chronic ischemia cerebrovascular disease and its
sequelae.
Ergots,ginkgo bilaba extracts.
4.Drugs understudying
Free radical scavengers,receptor antagonists of excitatory amino acids、drugs on
the RAS.
Chapter 19
Drug dependence and abuse
【Aims and requirements】
1. Master the mechanisms and harm of drugs that commonly abused such as opioids,
cocaine, marijuana, nicotine, alcohol.
2. Master the addiction of drug and treatment.
3.Familiar with the administration regulation of the drugs that have
dependence-potential.
4.To know well the terms: drugs, dependence, tolerance, addiction and abstinence
syndrome.
5. Familiar the classification of the dependence-potential drugs and administration
regulation.
【Teaching hours】: 2 hours
【Teaching contents】
1. Terms related drug abuse and drug dependence.
Dependence，physiological dependence and psychological dependence, addiction drug
abuse.
2. The harm of the drug abuse.
3. Classifications of the dependence-potential drugs.
(1)Narcotics: opioids, cocaine, marijuana, nicotine, alcohol.
(2)Psychological drugs: central simulants, hallucinogens and others.
3. The manifestation of drug dependence.
4. brain reward system and drug dependence.
(1)Reinforcement and reward
(2) The biology of drug reinforcement.
(3) Receptor mechanism of drug reinforcement.
5. The mechanisms of drug dependence.
(1) Opioids and receptors
(2) Cocaine and transport of monoamines.
(3) Alcohol and sedative-hypnotics affect GABA.
(4) Marijuana and its receptors.
(5) Hallucinogens (lysergic acid diethylamide, LSD) activate 5-HT2A receptors.。
6.The treatment of drug dependence
(1) Opioids：
The goals of treatment ： from dependence to detoxification, maintenance of
detoxification. Maintenance therapy involves the use of a drug such as methadone to
continue opioid dependence while psychological, social, and vocational therapies are
used to support the user during abstinence. Detoxification is used to treat physical
dependence and consists in reducing the drug doses administered.
Real opioid de-addiction includes:
de-addiction or control abstinence syndrome;
physical and psychological recovery；
Prevention of relapse: naltrexone, a long-acting orally active pure narcotic antagonist,
to block the action of self-administered opiates.
Substitution of a longer-acting，orally active, pharmacologically equivalent for the
abused drug：Long-acting methadone analog, levo-methadyl, maintenance for heroin
addicts (active 72 hr).
Buprenorphine can also prevent opioid withdrawal.
If short-acting sedative drugs have been abused, phenobarbital is substituted as the
pharmacologically equivalent agent. If long-acting drugs have been used, the same
drug may be continued.
Clonidine, a centrally acting sympatholytic agent, reducing the outflow of NA,
mitigating many of the signs of sympathetic overactivity.
(2) Alcohol withdrawal：Substitution of a less reinforcing drug and gradually reducing
the dosage to lessen withdrawal syndrome: Benzodiazepines for alcohol withdrawal.
Aversive agents that interacts with the drug to produce an unpleasant instead of
rewarding effect. Disulfiram in the treatment of alcoholics.
(3) Cocaine and amphetamine: Use of specific blockers to prevent the reinforcing
effect of drugs: α-methyl-p-tyrosine to prevent amphetamine "high" extinction.
Ondansetron（奥丹西隆）or buspirone（布斯哌酮）can suppress drug seeking behavior,
Antidepressants for underlying depression or antipsychotics for schizophrenoform
psychosis haloperidol(氟哌啶醇).
(4) Drug abuse control
Chapter 20 Clinical Examination
【Aims and requirements】
1. To understand the principles of taking a patient’s history.
2. To understand the principles involved in performing a mental state examination.
3. To understand the principles involved in performing a neurological examination.\
4. To be familiar with the major clinical laboratory techniques.
【Teaching hours】: 2 hours
【Teaching contents】
1.Taking a patient’s history
2. Neurological examination
①General examination：Consciousness, mental state, intelligence, language.
②Cranial nerves：anatomy of 12 cranial nerves, clinical manifestations of cranial
nerves lesion, examination methods .
③Motor function
a. Muscle bulk:
b. Muscle tone：Hypermyotonia、hypomyotonia.
c. Muscle strength：Measurement of muscle strength (5 grade).
d. Reflexes
Deep tendon reflexes: Biceps reflex, triceps reflex, knee reflex, ankle reflex
Superficial reflexes: Abdominal reflexes, plantar reflex; cremasteric reflex
Pathologic reflexes : Babinski sign
e. Motor coordination: Finger to nose, rapid alternating movements, heal –knee shin
f. Involuntary movement
g. Stance and gait
④Sensory function
The types and examination of sensory：special sense，superficial、deep sense，
combination sense.
3.Commonly used laboratory techniques of neurological diagnosis:
Cerebrospinal fluid inspection, CT, MRI, DSA, EEG, EMG, PET, and so on.